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Bucket handle tear of medial meniscus

Case contributed by Utkarsh Kabra
Diagnosis certain

Presentation

Twisting injury of the knee.

Patient Data

Age: 25 years
Gender: Male

Partial-thickness tear of anterior cruciate ligament near its femoral attachment. Few fibers are however seen in continuity. 

Large tear of body of medial meniscus with blunting of anterior and posterior horns, large displaced meniscal fragment seen in medial aspect of intercondylar notch, anterior to posterior cruciate ligament.

Edema at meniscocapsular junction. 

Grade II sprain of posterior fibers of the medial collateral ligament at its femoral attachment. 

Grade II sprain of mid-segment and femoral attachment medial patellofemoral ligament. 

Partial tears of posteromedial joint capsule including posterior oblique and oblique popliteal ligaments seen. 

Large lobulated Baker’s cyst with fluid tracking along medial aspect of medial head of gastrocnemius muscle possibly dissecting cyst.

Hyperintensity along infrapatellar plica with surrounding fat stranding – possibly infrapatellar plica injury. 

Subtle subchondral marrow in medial tibial condyle. 

Case Discussion

In a case of partial tear of ACL, large tear of body of medial meniscus with blunting of anterior and posterior horns, large displaced meniscal fragment in medial aspect of intercondylar notch, anterior to posterior cruciate ligament consistent with Bucket handle tear of medial meniscus. It shows the classical 'Double PCL sign'.

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